The purpose of this study is to develop evidence regarding the role nurse competency plays in reducing risk of patient harm and impacting patient outcomes in Veterans Administration Medical Centers (VAMC) with acute inpatient facilities. Specific aims of the study are to determine if associations exist between VAMCs' proportions of certified RN staff and three post-operative patient outcomes, 1) failure-to-rescue, 2) pneumonia, and 3) deep vein thrombosis (DVT), controlling for IN education level, experience, total number of RN hours, skill mix, and facility National Surgical Quality Improvement Program (NSQIP) category. Model testing methodology, inclusive of descriptive statistics, correlation analyses, and multiple regression, will be used to conduct secondary analyses of data collected previously in the Nurse Staffing and Patient Outcomes in Veterans Administration Medical Centers study (NSPOVA) (MR 01-160). Findings from the study will provide understanding of nursing's critical role in improving the quality of life and improving the quality and cost-effectiveness of care. [unreadable] [unreadable] [unreadable]